Reducing Mastoplasty

This is for patients with big and fallen breasts; these big breasts are 70% fat and 30% mammary tissue, with a tendency for the tissues to degenerate and produce progressive fibrous nodules. Cervical pain, kyphosis (bending) and other disorders are also present in the patients.

Surgery is really indicated for these patients, but it is important to explain them about the size of the scars, since they are large compared to the ones from prosthesis placement. They are usually around the areola; vertically go down and extend though the mammary crease horizontally.

Thanks to the technique evolution, nowadays, we no longer leave scars at the level of the mammary crease, but only the areolar and the vertical ones. Sometime ago the areolar scar was preconized, technique called periareolar, but the results did not satisfy the doctors and neither the patients, and that is the reason why nowadays it is used for the mammary reconstruction, while the esthetic application was differed. There exists a global tendency to realize smaller scars every time; however, the length of the scar will depend on the patient.

It is also normal that one of the breasts is bigger than the other, or one is more fallen. These asymmetries can be corrected by the plastic surgeon during the surgery. It is an elaborated and not easy surgery, and possible complications have to be informed to the patient: areola’s necrosis, wide and non esthetical scars, keloids or scars with relief, hematomas, infections, etc. Fortunately their indexes are low, but the surgeon must solve them if they existed.

It is an ambulatory surgery in which the patient returns home on the same day and comes back to the clinic the next day for cure. If the patient does not live in our city, we will make sure she has assistance during the postoperatory until is good conditions as to go back to her permanent residence.

Mastopexy

With ageing added to hormonal and weight changes post-pregnancies, the breast usually descend (ptosis). If the woman looks at herself on the mirror and the nipple is at the same level as the mammal crease, then she has a grade I or light mammary (down-fallen) ptosis; if the nipple is under it, the grade is II or moderate; if the nipples are oriented to the floor it is a grade III or advanced.

Many women think that an implant solves the whole theme. It is more complex than that since the implants increase the size and may correct a light ptosis or grade I, but what really should be done is a surgery that reposition the inferior pole tissues creating with the patient’s own tissue a natural prosthesis that will get fixed to the pectoral muscle, to prevent the breast fall (inferior pedicle hanging).

The scars are similar to the ones provoked by breast reduction, one at the areola and another vertical.

This is also an ambulatory surgery, and it is realized under local anesthesia with sedation, thus the patient does not feel any pain during the surgery.